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The people who cared for a COVID-19 patient: How a single case was handled – Vernon Morning Star

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The call came in on an afternoon in March: a patient at a medical clinic in Vancouver complained of chest pains.

Paramedic Jeffrey Booton watched the details flash across the screen as he and his partner made their way to the clinic.

It was his first potential case of COVID-19 and he felt both trepidation and a sense of duty.

“I see this job as working in the service of people. And getting to do so in the context of a pandemic is obviously wrought with fear and apprehension some days, but it’s work that still resonates with me,” he said.

When Booton arrived, he put on protective gloves, a fluid-repellent gown, N-95 mask and face shield over his freshly buzzed dark hair — an at-home haircut that turned out shorter than planned.

After a physical exam, they got back in the ambulance and Booton did what he always tries to do: comfort the patient. Paramedics see people during what can be pivotal personal moments and Booton felt the weight of the patient’s worry. As they travelled together towards St. Paul’s Hospital, he told the patient what he could expect in the emergency department and what types of tests he might undergo.

“I can only imagine what he was feeling in that moment, but it must have felt like a true sense of vulnerability to what uncertainty lay ahead,” Booton said.

Booton was one of at least 125 health workers, ranging from dispatchers and nurses to hospital housekeepers, who cared for the patient.

On that day, the patient was among 55 identified by dispatchers as possible COVID-19 cases in Vancouver.

Since the pandemic began, more than 50,000 people in Canada have tested positive for the new coronavirus, and federal government figures say at least 2,900 people have been hospitalized.

This is the story of those who cared for a single case at St. Paul’s.

In the emergency department

Dr. Shannon O’Donnell knew she had only a few minutes to prepare after paramedics phoned the hospital to warn that a suspected COVID-19 case was on the way.

“I was a little anxious,” she said. “We don’t know what we’re getting, how much distress a patient is going to be in or how sick they’ll be. And you know, you’re worried also about being exposed to infection.”

The department had been eerily quiet after beds were vacated and the workflow was overhauled to make room for a possible surge in COVID-19 cases, O’Donnell said. Provincial health officer Dr. Bonnie Henry recently announced the province has been able to control the spread of the virus, but the caseload was still growing when the patient arrived.

The paramedics brought the patient directly into a negative pressure room set up for high-risk cases. Glass walls allow for filtration changes to reduce the risk of the virus spreading by air.

Like everyone the patient would interact with, O’Donnell examined him through a heavy armour of personal protective equipment. He was one of the sicker patients she’d seen.

“What was most striking to me was that he did require oxygen, but he also had a very high respiratory rate. He was breathing 30 breaths per minute, whereas you or I would breathe 15 or 16 breaths per minute,” she said.

COVID-19 has transformed not only the hospital but O’Donnell’s home life, too. She and her husband, also an emergency doctor, juggle the full-time care of their three children at home since schools closed.

Together, they decided that if there were a major outbreak, one would work at the hospital and self-isolate from the family, while the other would care for the kids.

“My husband likened it to both of us running into a burning building at the same time.”

O’Donnell ordered blood work, chest X-rays and an electrocardiogram scan, and conducted a chest ultrasound with the help of registered nurse Rachel Mrdeza.

For Mrdeza, some of the hardest cases have been the older patients who arrive incredibly short of breath, with a fever and chest tightness. Emergency department workers don’t typically learn if patients have COVID-19 because the test results come back after they move on from their care, but there can be strong evidence of the virus.

“You know they’re in the window of vulnerability for having quite a dire outcome from COVID. That is really hard to see,” she said.

Under normal circumstances, the emergency doctor would work with several nurses but only one is allowed in the isolation room at a time to protect against contagion.

By the time QianQian Wu began her night shift, she was only the third nurse to see the patient.

Despite the promising case numbers in B.C., Wu said staff don’t feel like they can relax. St. Paul’s Hospital is the main treatment centre for vulnerable residents on the city’s Downtown Eastside, a neighbourhood that faces another public health emergency from the overdose crisis.

Wu began her shift by putting on the uncomfortable protective gear that she would wear all night. She tries to stay hydrated before work because she knows she can’t drink water with the mask on.

“It’s a little hard to breath sometimes,” she said. “And sometimes you get sleepy with it on for a long time, it’s very warm.”

Wu took the patient’s vitals and talked to him about his family and friends. She also noticed his laboured breathing.

The testing process

While the patient waited in the emergency department, blood samples and swabs were sent to the hospital’s laboratory.

Dr. Marc Romney, medical director of medical microbiology and virology, said manual molecular testing for COVID-19 typically requires five to 10 lab staff.

“It’s not like a pregnancy test you get from London Drugs, it’s much more complicated,” Romney said.

A porter transports the specimen, a technologist reviews whether it was ordered and labelled properly, then two or three technologists conduct a multistep process involving the extraction, purification, amplification and detection of the virus’s genetic material. A senior technologist and one or two physicians review the results before they are sent back to the attending physician and infection control team.

But the virology lab was transformed by the arrival of a machine in March that automates part of the process.

The Roche cobas 6800 system was adapted from HIV testing and lifted the lab’s theoretical capacity up to 2,000 tests per day, in combination with manual testing.

WATCH: New COVID-19 testing machine takes load off B.C.’s virologists and labs

Romney excitedly talks about the changes and ideas they’ve come up with to deal with the pandemic.

“One of the machines that’s called an extractor, we had to be creative to bring it into the lab because we didn’t have a lot of capital dollars to do it, so we basically bought it off the internet second hand,” he said.

“We’re under tremendous pressure to deliver, it’s been a challenging time. But we’re pleased.”

It has also come at personal cost.

One technologist was basically living in the lab and sleeping only five hours a night.

Romney went weeks without a day off and didn’t see anyone in person beyond his immediate family and colleagues.

When 19 positive tests came back in a single day, another doctor “basically ran from her home” to the hospital to start communicating the results to doctors, public health officials and others who required the information, Romney said.

“The front-line workers are amazing, and we are here to support them but I think it’s good for people to know there are also a lot of people behind the scenes working on this too,” he said.

“It’s not just machines that are being plugged into walls, it’s very human what we do here.”

Romney said the lab staff are mindful that time is critical in fighting the virus.

“It’s a sacrifice but we understand the importance of what we’re doing and there’s kind of a window of opportunity to try and contain the virus. Part of that is testing.”

The transition team

More severe suspected COVID-19 cases are sent to the intensive care unit for isolation. Back in the emergency department, Dr. O’Donnell called Dr. Mathieu Surprenant for an assessment while they awaited test results.

The 29-year-old clinical associate put plans to move back to Montreal on hold when the pandemic struck. Moving in with other doctors seemed too risky, so Surprenant remained in his nearly empty apartment in B.C. on an extended lease.

“I’m sleeping on my inflatable mattress and I’m trying not see anybody,” he said, laughing.

“It’s been very lonely because when I’m not working, I’m not doing anything.”

When he got the call from emergency, Surprenant headed downstairs with resident Dr. Charles Yang.

This wasn’t the hospital’s first suspected COVID-19 case and Yang found himself wondering if it would follow the same trajectory as others.

“In my mind I was wondering, OK what are the precautions I need to take in order to protect myself and other patients while maintaining the level of care I would typically provide for a patient,” Yang said.

He thought of his fiancee at home and whether he would be putting her at risk.

The team examined the patient to develop his care plan. They looked at his oxygen levels and also at the patient himself. Did he look comfortable? Was he struggling?

“What we’re sort of afraid of is that they reach a certain point where they’re able to compensate with their own physiology and eventually just tucker out and decline at a rapid pace,” Yang said.

A crash intubation would be risky for staff because of the time it takes to put on protective equipment, and a chaotic rush into an isolation room could spread the infection. A care plan puts everything in place for a controlled intubation, if a patient appears likely to decline.

The team talked it over and the patient was transferred to the ICU for monitoring overnight.

But it wasn’t long before his oxygen levels began to concern Surprenant.

Best practices change rapidly as new information becomes available about the new coronavirus, the doctor said.

Initially, for example, the idea was to intubate as soon as possible because if a patient gets too ill, his chance of dying on a ventilator increases. But intubation is also more invasive than other procedures and risky for health workers because it pushes droplets of the virus into the air.

Since the pandemic began, recommendations have relaxed to allow for other treatments first but it’s a constantly moving target, Surprenant said.

He believed the patient had reached the stage where intubation was his best chance at survival.

Making that call meant calling in a group dubbed the COVID airway team. Early in the pandemic, the experts in both airway management and donning and doffing specialized protective gear waited on call in a hotel across the street.

“Just dressing takes between five and 10 minutes,” Surprenant said. “They look like astronauts with all the layers.”

The COVID airway team

Anesthesiologist Dr. Shannon Lockhart was part of the planning group that conceived of the COVID airway team.

The cancellation of elective surgeries meant the traditional workload for Lockhart and her colleagues would be lighter. Their idea was to form teams with respiratory therapists to perform intubations so that emergency and ICU doctors wouldn’t expose themselves to the high-risk procedure.

Anesthesiologists self-selected into one of three groups: The first wave was ready to start serving on the COVID airway team immediately. The second would step in if the first wave got sick. And the third would not participate because they or their loved ones were at risk of serious illness if exposed to the virus.

For Lockhart, the decision to be part of the first group, known as the “green team,” was easy. The hard part was creating a plan that would call on others to face the same risk.

“I’m 35 years old, I’m young and healthy. I have a family who is young and healthy, so the personal risk was pretty low for me,” she said.

“More challenging for me was identifying this was a useful model for our group, who are my colleagues and friends, and thereby potentially offering the services of people and putting them at higher risk.”

The uptake was good, however. She was among 16 who volunteered for the green team, making it viable.

When Lockhart was called to intubate the patient, she was ready.

“He fit the story of what you hear about COVID patients who look really well from the bedside, but their numbers don’t look that great,” she said.

Putting a breathing tube down a patient’s throat under normal circumstances takes between five and six minutes, she said.

That time frame has ballooned to between 60 and 90 minutes dealing with the extra protective gear, preparing every possible material you could need in isolation, and the cleaning or disposal of everything in the room.

Dressing feels like a race when someone is struggling to breathe. Once inside, the urgency to clear the airway is intensified by the heat the suit produces.

“The longer we’re in the room, the hotter we get and the foggier our eye protection becomes,” Lockhart said.

Lockhart and a respiratory therapist gave the patient a sedative and paralytic, and inserted the breathing tube while another anesthesiologist waited outside as backup.

Working with different colleagues in an unfamiliar setting wearing cumbersome new equipment is stressful, Lockhart said. But she’s been heartened to watch hospital staff quickly respond and break down silos in which they typically operate.

After intubating the patient, the riskiest part of Lockhart’s new job is doffing her gear.

As the patient relies on strangers for care, Lockhart too relies on someone she barely knows for her own protection. She and the respiratory therapist watch one another carefully as they remove the equipment piece by piece, monitoring for any slip that would allow contamination.

“It’s kind of an interesting position to be in when you’re trusting this person with this very important task but you may never have met them before.”

Inside the intensive care unit

When Dr. Gavin Tansley met the patient, he was already sedated and breathing through a ventilator.

Tansley had given the OK for intubation when Surprenant woke him up with a phone call. He was already familiar with the patient’s case.

Where possible, ICU staff keep an eye on patients they might inherit from other departments, said Tansley, a general surgeon training in critical care. They ask themselves, if things get worse, what would we do?

In the ICU, the acute focus on ventilation shifts to the more holistic care of all the patient’s major organ systems.

“Critical illness is a bit of a funny thing where you really do recognize how intertwined all of these organ systems are,” Tansley said.

“With COVID in particular we see very familiar patterns where often times the kidneys won’t be working 100 per cent, sometimes the heart won’t be working 100 per cent. So, we need to support those organs with other medications or sometimes we need to add dialysis or additional interventions to optimize things as best we can while the body tries to deal with that virus.”

When Tansley decided to become a doctor, he wanted to help people heal. He didn’t realize then that in the ICU, he wouldn’t get to know his patients very well.

“Very often by the time I meet patients, they’re already sedated or on a ventilator or so sick that they can’t talk to you. So, your relationship becomes with the family, and you develop amazing relationships,” he said.

Reflecting on the case, Tansley said it reinforced some recent thoughts he’s had about critical illness that don’t get discussed. So much focus is on the patients, but their families are often experiencing trauma.

“Conversations we’ve had with this particular family reinforced that he was very, very cared for within this family and they were very much struggling with the fact that he was unwell.”

Being unable to visit their loved ones during the pandemic has added an extra layer of grief, he said.

It has been hard for staff to keep families from their loved ones, but they are finding ways to help them connect. Tansley sets aside time to phone them with updates. Nurses hold iPads up to patients so their families can at least see them on video.

Whatever they try, it’s not the same as being able to hold a loved one or even sit with them. The grief can add an extra layer of emotional stress for health workers as well.

“It’s just one of the many ways the coronavirus has changed the way we have to practise medicine.”

A look at the recovery

By the time the patient reached the ICU, about 25 health workers had already played a role in his case. Some interacted with him directly, while others played important but indirect roles in his care, ranging from hospital housekeepers to X-ray technologists.

About 90 intensive care staff saw him, and from there, he would be turned over to a general medicine team.

Recovery is a long road involving a wide network of specialists from dieticians to speech pathologists and social workers. Behind the scenes, hospital administrators, education and outreach teams also do their part.

Kevin Novakowski is a respiratory therapist and in his 28 years of work, he’s never felt an illness create such a constant psychological burden.

“It’s changed me in a way,” he said. “It’s kind of always on my mind.”

In recovery, a patient begins physiotherapy to build his strength. Novakowski is there monitoring how it affects his breathing.

It can take weeks to months, and some never fully recover. Between 30 and 60 per cent of survivors of critical illness have ongoing medical or mental health issues, said Dr. Del Dorscheid, who oversees the ICU as an attending physician. That can mean residual lung disease for COVID-19 survivors, whom he said may receive intensive care for a week or more than a month.

But the first major step toward independence is weaning a patient off the ventilator.

As Novakowski monitored the patient, he began reducing the ventilator’s power and gave him short trials without it.

“You’re looking at their breathing and watching them and focusing on how their muscles look. Are they struggling for air, are they taking deep breaths, are they breathing fast, are they breathing shallow?” he said.

Weaning is a gradual process, like an ebbing tide. Off the ventilator, a patient’s breath rattles.

“They cough and they sputter,” he said.

The rattle may disappear then return when they stand for the first time, or when they start walking.

It’s a stressful process for patients. If they don’t keep coughing to clear their airway, infections can return.

During those first trials, Novakowski waits and listens.

“You listen to them breathing,” he said. “And then all of a sudden, it’s just kind of really quiet and their breathing just sounds like our breathing, normal.

“And you think, OK. That’s good.”

Amy Smart, The Canadian Press

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Opioid crisis not going away amid pandemic, and will 'kill more Canadians,' says Dr. Daniel Kalla – CBC.ca

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As the country and the rest of the world grapple with the coronavirus pandemic, the opioid crisis threatens to deepen and “kill more Canadians,” says a Vancouver ER doctor.

“[COVID-19] knocked … opioids right off the front page,” Dr. Daniel Kalla told White Coat, Black Art.

“But this is a crisis that we both know isn’t going away.”

In British Columbia, a total of 113 people died of suspected illicit drug overdoses in March — the highest death toll in a year, according to the B.C. Coroners Service. Experts have warned fentanyl and other contaminants are still present in many illicit drugs.

Kalla says people were afraid to use safe injection sites or join other people because they feared contracting COVID-19.

“So there was an increase in users using alone which … can be suicidal for opiate users.”

In his latest novel The Last High, Kalla chronicles the search for a deadly form of fentanyl in Vancouver. He spoke to White Coat, Black Art host Dr. Brian Goldman about his experience working in the ER for more than 20 years, how it has shaped his books and the pandemic’s impact on the opioid crisis.

Here is part of their conversation.

Your latest book The Last High begins with seven teenagers partying. All of them [overdose]. Only two make it to the ICU alive. Eventually we learn that an ultra-powerful form of fentanyl and carfentanil are behind the deaths. It sounds ripped from the headlines. Has anything like that ever happened on your watch?

Not in that scale. I’ve seen a couple of kids come in — and overdose — who didn’t know they were taking fentanyl or opioids. I saw one tragic 21-year-old girl — who ended up brain dead — who is not a regular opioid user.

As much as anything, I meant this book to be a cautionary tale. I have a 19 and 22 -year-old [daughters], and it’s the message I wanted to get out there that this stuff is the ultimate Russian roulette that some people are playing with.

Daniel Kalla, shown here with his daughters, says The Last High is a cautionary tale about opioid use. (Submitted by Daniel Kalla)

I want to take you back to that to that 21-year-old. What was that experience like for you?

Most opioid overdoses either die in the field or they get Narcan [brand name], naloxone, an antidote.

And by the time we usually see them in the emergency, they’re generally wide awake.

And then there’s that slim proportion that’s in the middle — whose [hearts] stay alive long enough to get to hospital — but they’re effectively brain dead. And I described that in the novel a little bit.

With no sign Canada’s opioid crisis will improve in the near future, the federal government has announced dramatic steps to try and stop its spread 3:18

I had the sense immediately when I saw her that she probably was brain dead.

She was deeply comatose … but, you know, she had a blood pressure. Her parents were rushing in. 

It was very devastating because even though we were trying to resuscitate her, I [had] this sinking feeling at the pit of my stomach that she’s never going to wake up, and sure enough, the CT scan confirmed that the brain damage was already irreversible. 

And she died a couple days later.

Clearly as a fiction author you want to entertain, but I’m getting the sense just listening to you that there’s a serious message behind this book. What would you say that is? 

Opioids touch everyone whether you’re a direct user or you’re a friend or a loved one of a victim and … when you look at our hardest core street users, homeless addicts … no one would choose that lifestyle.

They have a genetic predisposition towards addiction.

They make some wrong choices, and they end up where they do. 

I have friends … non-medical friends [who say], “Well, you know, it’s sad about fentanyl, but that’s a ‘them’ kind of thing.”

And it’s not. It’s pervasive, it’s everywhere, it can touch you personally. 

Solving Canada’s opioid crisis is complex, and those on the frontlines of the epidemic say over-prescribing, tainted drugs and housing issues are creating the perfect storm. 11:30

Based on your experience as an emergency physician, but also having conversations with your undercover police officer [Kalla’s source of background for his novels], any ideas on how to solve this crisis?

I’m one of those people who … first and foremost, believes in harm reduction at the top of the list and treating substance usage as a disease and getting them help and therapy. 

Second of all, stop treating users as criminals and treat them … as patients. 

The war … against drugs has never worked in the history [of] any country that’s tried it.– Dr. Daniel Kalla

Third of all, I think you need to decriminalize the drug. If we had control over the source, and you weren’t bringing in this dynamite that they’re using, we could control the death rate for sure.

The war … against drugs has never worked in the history [of] any country that’s tried it, and I think we really need to change the attitude. 

We have to stop the criminal supply of fentanyl that’s being shipped into the country,

But as long as people don’t have an alternative, they’re going to turn to the illegal dangerous stuff.

What are the lessons from the COVID-19 pandemic that you think might inform us on how to meet the needs of the patients you see?

Kalla says the opioid crisis is going to kill more Canadians and be with us long after the pandemic. (Submitted by Daniel Kalla)

I’ve been so generally impressed in the level of our response … the effort that we’ve put in, the innovativeness. 

We basically rejigged our entire emergency department  … we had, not just money, but thought and effort and dedication, and, you know, we saw a result right away.

I think the same thing can be applied to [not] just the opioid crisis, but the mental health crisis and the homelessness crisis. 

Obviously the pandemic gave us a pretty strong stimulus, but at the end of the day … I think the opioid crisis is going to kill more Canadians, certainly more young Canadians for sure, and be with us long after the pandemic.

You write fiction and sometimes real life is stranger than fiction. So let’s end our conversation on this. How do you think COVID-19 ends?

I keep hearing mixed things about how long the vaccine will take and … if ever they will get one. 

I think until we have that vaccine, or at least a very good treatment, which personally I think will come first — I think it’ll be like a cocktail HIV drug kind of treatment that will manage the sickest, and we reduce the death rate. 

Until then, I think we’ll see a rolling series of small little waves … that will lead to all kinds of, you know, social distancing.

We’ll move forward in these phases that Canada’s proposing now, and then we’ll have an outbreak, and we’ll all be stuck indoors for a couple of weeks again.

I don’t see any way around that because I don’t imagine natural herd immunity developing [with] this virus unless it has a horrific death toll across the world.


Q&A edited for length and clarity. 

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N.S. reports no new COVID-19 cases, gathering limit increased to 10 – CBC.ca

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With no new case of COVID-19 being reported for the first time since March 15 in Nova Scotia, the province is increasing the number of people allowed to gather from five to 10.

“Today we come before you with good news. No new cases to report. Zero. That’s exciting,” Premier Stephen McNeil said at a press briefing on Friday.

Dr. Robert Strang, Nova Scotia’s chief medical officer of health said zero cases is a “significant and encouraging milestone.”

The new gathering limit is effective immediately, but physical distancing — except among members of a household or family bubbles — is still required.

The limit is the same indoors and outdoors, with an exception for outdoor weddings and funeral services, which can have 15 people.

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“I hate to be a damper on these joyous events, but at this time we need to make sure that the numbers are limited so the officiant is the only extra person and if you want a photographer or a DJ or something like that, they would be included in your number of 10 indoors and 15 outdoors,” Strang said.

The 10-person limit applies to:

  • Social gatherings.
  • Arts and culture activities like theatre performances and dance recitals.
  • Faith gatherings.
  • Sports and physical activities.

Strang said for faith gatherings, safety precautions are required. He said passing around a collection plate is not allowed. Strang said singing is highly discouraged because “people singing can significantly increase the spreading of respiratory droplets, [which] increases the risk of transmitting the virus that causes COVID-19.”

It also applies to businesses that are too small to ensure physical distancing.

Reopening timelines announced for campgrounds

The province also announced timelines for the reopening of more businesses:

  • Starting June 5, private campgrounds can open for all types of campers. But they can only operate at 50 per cent capacity and must ensure public health protocols are followed.
  • Provincial campgrounds will open to all Nova Scotians June 15, with the reservation line opening June 8. Those campgrounds will operate at a reduced capacity.
  • Pools can begin maintenance work to prepare for reopening, likely in time for summer.
  • Sleepover camps are not permitted this year.

Two things not changing are the requirement of self-isolating for 14 days when people visit Nova Scotia, and the household bubble is not expanding.

Nova Scotia Chief Medical Officer of Health Dr. Robert Strang called the announcement of zero new COVID-19 cases a ‘significant and encouraging milestone.’ (CBC)

“I know some of this is confusing. People say, ‘I can go to a restaurant and there will be 10, 20, 30 people in that restaurant as long as the tables are kept apart.’ That seems to be OK, but they can’t go hug their grandparents or they can’t go practise with their soccer team,” Strang said.

“It’s important that people understand we recognize those, but this is about taking measured steps so we can reopen the economy, loosen restrictions in a carefully, measured way.”

In a news release Friday, the province said the microbiology lab at the QEII Health Sciences Centre completed 1,034 tests on Thursday.

Why daycares are reopening later

McNeil addressed why daycares aren’t reopening at the same time as many other businesses on June 5.

He said he wanted daycares to reopen at the same time as everything else, but public health made a recommendation against it, so the date was moved from June 8 to 15.

“When public health comes to me and says the plan is not ready and they need another week, why would I go against that? That is about the safety of our children,” McNeil said.

Nova Scotia Premier Stephen McNeil said the decision to push back the reopening of daycares from June 8 to June 15 was made based on a recommendation from public health. (CBC)

He said “too many provinces” reopened daycares too soon and “look what’s happened in those provinces.”

“Some of you are saying, ‘Why didn’t you change the date of the economy?’ Because people have to get back to work to pay the bills and take care of their families,” he said.

McNeil acknowledged the 10-day difference “will be long for people going back to work right away and [who] need child care.”

Respect employees having child-care issues

McNeil asked businesses to “please respect” employees who have “issues with child care” over that 10-day period.

“We need to take care of each other, we need to be kind to each other, we need to support each other as our province tries to come back from COVID-19,” he said.

McNeil closed the briefing by addressing people who are asking about expanding their household bubble and “get the long-awaited hug.”

Provincial campgrounds, such as Rissers Beach Provincial Park in Lunenburg County, will open to all Nova Scotians June 15. (Submitted by the Department of Natural Resources)

“A hug is a beautiful and dangerous thing,” McNeil said. “Close contact means so much to us, but it is the very thing that could set our province back.”

McNeil said people can “hang out” now and grandparents can “watch your grandchildren play.” But to protect everybody, he said hugs, kisses and handshakes are off limits.

“Stay six feet apart a little longer,” he said. “If we continue to flatten the curve, we’ll be able to lift up your spirits by taking down more restrictions.”

Outdoor weddings are an exception to the gathering limit and are allowed to have 15 people, rather than 10. (Christian Petersen/Getty Images)

There remain 18 active cases of COVID-19 in the province, 14 of which are residents and staff at the Northwood long-term care home in Halifax. There are eight people in hospital, including three people who are in the intensive care unit.

Northwood remains the only long-term care facility in the province with active cases.

In an interview Friday, Northwood CEO Janet Simm said it was the first day “in a number of weeks” the facility had no new cases to report.

The Nova Scotia Health Authority’s COVID-19 map for Friday, May 29. (Nova Scotia Health Authority)

“So we’re celebrating that within the facility,” she said.

Fifty-nine people in Nova Scotia have died from the virus, 52 of those at Northwood.

Simm said 179 residents in Northwood had recovered as of Friday.

The state of emergency declared under the Emergency Management Act on March 22 has been extended to June 14.

Updated symptoms list

The list of COVID-19 symptoms recently expanded. People with one or more of the following updated list of symptoms are asked to visit 811’s website:

  • Fever (chills, sweats).
  • Cough or worsening of a previous cough.
  • Sore throat.
  • Headache.
  • Shortness of breath.
  • Muscle aches.
  • Sneezing.
  • Nasal congestion/runny nose.
  • Hoarse voice.
  • Diarrhea.
  • Unusual fatigue.
  • Loss of sense of smell or taste.
  • Red, purple or bluish lesions on the feet, toes or fingers that do not have a clear cause.
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Testing underway after 8 migrant workers at Elgin County farm test positive for coronavirus – Global News

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Officials with the Middlesex-London Health Unit (MLHU) and Southwestern Public Health (SWPH) say coronavirus testing is underway at a St. Thomas-area farm after at least eight temporary foreign workers tested positive for the virus this week.

An outbreak was declared on Thursday at Ontario Plants Propagation, a greenhouse operation along John Wise Line, days after the MLHU said it first became aware of a case Monday night involving a worker at the farm, health officials said on Friday.


READ MORE:
New Brunswick reverses ban on temporary foreign workers

That initial case led to 16 of the worker’s close contacts being tested on Tuesday, with seven of the tests coming back positive. As those workers live in London, the seven are included in the tally of new cases that was reported on Friday by MLHU.

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According to the health unit, another 40 workers living at the same complex as the first case were tested on Wednesday at London’s Carling Heights Assessment Centre.

The remaining workers in the group, meanwhile, were to be tested on Friday at Ontario Plants Propagation. Test results for all were expected over the coming days.

“The operator of this farm has been tremendously co-operative with us, and we believe that this outbreak is now contained,” said Dr. Alex Summers, associate medical officer of health with the MLHU, during Friday’s coronavirus media briefing.

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“Of course, we will be monitoring that very closely over the next couple of weeks.”






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Coronavirus outbreak: How the pandemic has exposed the vulnerabilities in the food supply chain


Coronavirus outbreak: How the pandemic has exposed the vulnerabilities in the food supply chain

Summers said the workers had arrived primarily from Guatemala and Jamaica, and that as far as the health unit was aware, all had quarantined for 14 days upon arriving in Ontario.

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The workers are currently in self-isolation, and none have been admitted to hospital.

Health officials are still working to find the source of the outbreak, but Summers said it was believed they had been in Canada long enough that they either contracted it here, or “one of the other workers may have had mild symptoms that weren’t identified and transmitted it subsequently to their colleagues.”

“We believe that we have readily identified all close contacts and any additional cases,” Summers said. “Of course, we continue to watch for further results. But those tests have been done.”

Health officials stressed there was no risk to the public from the products grown on the farm, and that they didn’t believe there had been any close exposure or close contact outside of the migrant farmworker community.

“The living conditions for these migrant farmworkers were certainly a congregate living setting, but not exceptionally crowded, nor of specific concern for us,” Summers said.

“They were people living together and that would have resulted in the transmission.”


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COVID-19 cases have also been reported at other southwestern Ontario farms during the pandemic.

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Fifty-one workers, local and foreign, at Greenhill Produce in Kent Bridge, Ont., tested positive for the coronavirus last month.

In Windsor-Essex, at least 16 workers from three farms in the region had tested positive for the virus as of early this month, the region’s health unit said.

In March, four workers tested positive at Highline Mushrooms in Kingsville, Ont.

Approximately 20,000 migrant workers come to the Ontario each year to work on farms and in greenhouses.

— With files from Shawn Jeffords of The Canadian Press

© 2020 Global News, a division of Corus Entertainment Inc.

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